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Nutrient Requirements

Long-Term Ovo-Lacto Vegetarian Diet Impairs Vitamin B-12 Status in Pregnant Women¹

Corinna Koebnick², Ingrid Hoffmann^*, Pieter C. Dagnelie, Ulrike A. Heins^*, Sunitha N. Wickramasinghe^**, Indrika D. Ratnayaka^**, Sindy Gruendel, Jan Lindemans and Claus Leitzmann^*

German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; ^* Institute of Nutritional Science, University of Giessen, Germany; Department of Epidemiology, Maastricht University, The Netherlands; ^** Department of Haematology, Faculty of Medicine, Imperial College, St Mary’s Campus, London, UK; and Erasmus MC, University Medical Center Rotterdam, The Netherlands

²To whom correspondence should be addressed. E-mail: Koebnick{at}mail.dife.de.

A well-planned vegetarian diet has been stated to be adequate during pregnancy. The aim of the present study was to compare serum vitamin B-12 and homocysteine concentrations in pregnant women (n = 109) consuming vegetarian and Western diets and to evaluate the adequacy of current dietary reference intakes of vitamin B-12 for these women. Pregnant women adhering to vegetarian diets for at least 3 y, with subgroups of ovo-lacto vegetarians (OLVs; n = 27), low-meat eaters (LME, n = 43), and women eating an average Western diet (control group, n = 39), were recruited. Dietary vitamin B-12 intake, serum vitamin B-12, and plasma total homocysteine (tHcy) concentrations were measured in wk 9–12, 20–22, and 36–38 of pregnancy. During pregnancy serum vitamin B-12 concentrations of ovo-lacto vegetarians (P < 0.001) and low-meat eaters (P = 0.050) were lower than those of the control group. We observed the combination of low serum vitamin B-12 concentrations and elevated plasma tHcy in 22% of ovo-lacto vegetarians, in 10% of low-meat eaters, and in 3% of controls (P = 0.003). In OLVs, serum vitamin B-12 predicted 60% of the plasma tHcy variation (P < 0.001), but in LMEs and controls only <10% (NS). Serum vitamin B-12 concentrations increased and plasma tHcy decreased sharply with increasing dietary intake of vitamin B-12 toward a cutoff point of 3 µg/d. Pregnant women consuming a long-term predominantly vegetarian diet have an increased risk of vitamin B-12 deficiency. Current recommended dietary intakes urgently need reevaluation.

KEY WORDS: • pregnancy • vitamin B-12 • homocysteine • vegetarian diets

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